Theoretical Background

The Avoidance-Endurance Questionnaire (AEQ) is a reliable and valid measure assessing both, fear-avoidance-related (FAR) and endurance-related (ER) responses to pain, theoretically based on the Avoidance-Endurance Model (AEM) of pain (Hasenbring 2000).

Basic assumptions of the AEM

  • Loose relations were hypothesized for the cognitive, affective and behavioral responses to pain.
  • Referring to the dynamic model of affect (DMA, Davis et al. 2004), it is assumed that the opposite pattern of FAR and ER may exist on distinct dimensions, which means that these features can be activated independantly. This assumption was supported by evidence of distinct neural systems for opposite affects and cognitions (Hass and Canli, 2008).
  • It is hypothesized that only specific, highly rigid and time-stable pattern of cognitive, affective and behavioral pain responses, will lead to a development of chronic pain and disability. FAR pattern: fear of pain, catastrophizing, behavioral avoidance. Depressive ER pattern: thought suppression, anxiety/depression, task persistence in spite of pain Happy ER pattern: ignoring or minimizing pain, task persistence, positive mood despite pain.
  • FAR pattern lead to disability via physical inactivity, disuse of muscles and deconditioning. Chronic pain is supposed as a long-term consequence of deconditioning.
  • ER pattern lead to a maintenance of pain via physical overuse/overload of muscles, bones and ligaments that cause repetitive small damages of physical structures. Disability is supposed as a long-term consequence of ongoing pain.